Terry Lee McCullough, MSW

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

9689166 Issued in MI

Practice address

01546 County Road 665
Bloomingdale, MI 49026-8756

Phone

(269) 512-6163

NPI assigned

Apr 27, 2022

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bloomingdale Senior Services LLC

  • In Home Supportive Care Agency
  • Bloomingdale, MI
  • NPI 1366178105
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1651017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1801530571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "01546 COUNTY ROAD 665",
            "city": "BLOOMINGDALE",
            "state": "MI",
            "postal_code": "490268756",
            "telephone_number": "269-512-6163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "01546 COUNTY ROAD 665",
            "city": "BLOOMINGDALE",
            "state": "MI",
            "postal_code": "490268756",
            "telephone_number": "269-512-6163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCULLOUGH",
        "first_name": "TERRY",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-27",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "MI",
            "license": "9689166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in Bloomingdale, MI
• Providers in Bloomingdale, MI by specialty
• In Home Supportive Care Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.